Informants were provided with a definition of MCOD (Gutierrez & Nagda, 1996; Jackson & Holvino, 1988) and asked to compare their practices with that model.
Analytical categories regarding MCOD processes were developed.
Respondents identified numerous challenges to fully conceptualizing and implementing MCOD efforts.
The practitioners, mostly managers or supervisors, were asked to describe the overall functioning of their agencies before, during, and after MCOD interventions; consultants were asked to share their observations of organizational functioning.
Despite this climate of demoralization, all the agencies represented by the practitioners forged ahead with some MCOD plans.
Few respondents indicated that MCOD was undertaken to challenge the dominant organizational culture, because it was a larger part of strategic planning, or because of management declaration.
Some daily realities were significant impediments to comprehensive MCOD.
Respondents indicated that a most serious and overwhelming challenge to MCOD is a troubled or unstable economy.
The other sociopolitical barrier to MCOD is local, focusing on the kind of relationship an agency has with the surrounding community.
Consequently, MCOD was set aside: "I want to do dialogues, workshops, and other multicultural learning activities, but the staff say they are overwhelmed.
There were significantly higher odds of a death certificate being assigned an undefined external cause code if the external cause was coded as an accident (compared with intentional self-harm), was a MCOD (compared to an UCOD), where the deceased was not Indigenous, where the death was certified by a doctor instead of a coroner, where the deceased was female and where the death was of an older individual.
Specificity was particularly problematic for causes assigned as MCOD rather than UCOD.